Abstract
BackgroundTo assess baseline quality of care in the Kyrgyz Republic in 2019 and determine the effect of online simulated patients in changing doctors’ practice in three specific disease areas: non-communicable disease, neonatal/child health, and maternal health.MethodsOver 2000 family health, pediatric, neonatology, therapy, and obstetric-gynecologic doctors from every rayon (district) hospital and at least one associated family health (Primary) care clinic participated. To adequately scale the project, the Ministry of Health used online simulated Clinical Performance and Value (CPV) vignettes. All doctors cared for the same set of patients in their clinical area. Over eight months in 2019, we gathered three rounds of CPV data in seven oblasts.ResultsOverall quality scores were highly variable at baseline (59.2% + 13.5%). After three rounds the average score increased 6.5% (P < 0.001). By the end of round three, the lowest scoring oblast was providing higher quality care compared to the highest scoring oblast in the initial round (64.2% in round 3 vs 62.4% in round 1), indicating greater adherence to the evidence base. Additionally, family health doctors ordered 26% fewer unnecessary tests (P < 0.05), while specialists ordered 39% fewer unnecessary tests (P < 0.05). If trends continue, this translates into a net annual savings of 63 million Kyrgyz som.ConclusionsThis study demonstrates serial measurement of care provided by over 2000 physicians in the Kyrgyz Republic can be improved as measured by CPVs. This project may be a useful template to improve health care quality at a national level in other low- and middle-income country settings.
Highlights
Correspondence to: Background To assess baseline quality of care in the Kyrgyz Republic in 2019 and determine the effect of online simulated patients in changing doctors’ practice in three specific disease areas: non-communicable disease, neonatal/child health, and maternal health
This study demonstrates serial measurement of care provided by over 2000 physicians in the Kyrgyz Republic can be improved as measured by Clinical Performance and Value (CPV)
We report on three rounds of CPV data collected from approximately 2000 respondents completed serially in all oblasts in Kyrgyzstan
Summary
Over 2000 family health, pediatric, neonatology, therapy, and obstetric-gynecologic doctors from every rayon (district) hospital and at least one associated family health (Primary) care clinic participated. All doctors cared for the same set of patients in their clinical area. Over eight months in 2019, we gathered three rounds of CPV data in seven oblasts. The QURE-Quality Improvement in Clinical Care for Kyrgyzstan (QuICCK) Project, under the aegis of the World Bank and the government of the Kyrgyz Republic, is a partnership between QURE Healthcare and the Ministry of Health of the Kyrgyz Republic (MoH) to improve quality of health care delivered in rayon hospitals and attached family medicine centers (FMCs) and general practice centers (GPCs). (See Box 1 for details on disease selection.).
Sign-in/Register to view highlights & summary 
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call